Holland/Adams/Brice, Core Concepts in Pharmacology 5th Edition Test Bank
Chapter 18

Question 1

Type: MCSA

A client is in chronic renal failure. Based on this diagnosis, what would the nurse anticipate the client might require regarding medications?

1. Higher dosages of medications than would a client with normally functioning kidneys
2. The same medication dosage as would a client with normally functioning kidneys
3. Lower dosage in most medications
4. A kidney transplant

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 276

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 18-3 Describe how pharmacotherapy is modified for patients with renal failure.

Question 2

Type: MCMA

The nurse is teaching a client who is diagnosed with renal insufficiency. Which functions of the kidneys should the nurse include in the teaching session? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Secrete the enzyme renin.
2. Stimulate red blood cell production.
3. Aid in digestion.
4. Regulate fluid balance.
5. Help maintain blood pressure.

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Page Number: 274

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 18-1 Explain the role of the kidneys in maintaining fluid, electrolyte, and acid–base balance.

Question 3

Type: MCSA

The nurse is instructing the client about different types of diuretics. What should be included in teaching?

1. All diuretics cause hyperkalemia.
2. Diuretics do not cause potassium to be lost in the urine.
3. Thiazide and loop diuretics cause potassium to be lost in the urine.
4. All diuretics cause potassium to be lost in the urine.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Numbers: 279–280

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 18-4 Identify indications and general uses for diuretics.

Question 4

Type: MCSA

The nurse is teaching a client who has been placed on a loop diuretic and requires a potassium supplement. What should the nurse include in the teaching session?

1. Do not use with antacids.
2. Tablets may be crushed or broken for easier swallowing.
3. Take on an empty stomach.
4. Take with food.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 287

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 18-5 Explain the role of loop diuretics in the treatment of fluid volume disorders.

Question 5

Type: MCMA

The client has a pH of 7.6. Which statements are appropriate based on this pH level? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. The client should be monitored for nervousness.
2. The client is alkalotic.
3. The client should be monitored for drowsiness.
4. The client is acidotic.
5. The client should be monitored for seizures.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 286

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 18-10 Identify common causes of acidosis and alkalosis and the drugs used to treat these conditions.

Question 6

Type: MCSA

A client has been admitted with a mild case of alkalosis. What would the nurse expect to be ordered?

1. 0.9 NS
2. 0.9 NS with 20 mEq potassium
3. Oral potassium supplements
4. Lactated Ringer’s solution

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 286

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 18-10 Identify common causes of acidosis and alkalosis and the drugs used to treat these conditions.

Question 7

Type: MCSA

Which medication is used to increase red blood cell production in patients with renal failure?

1. Mannitol (Osmitrol)
2. Chlorthalidone (Hygroton)
3. Epoetin alfa (Epogen)
4. Methazolamide (Neptazane)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 277

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 18-3 Describe how pharmacotherapy is modified for patients with renal failure.

Question 8

Type: MCSA

The client is taking furosemide (Lasix) 80 mg twice a day. What condition should the nurse monitor this client for?

1. Hyperkalemia
2. Hypercalcemia
3. Hypokalemia
4. Hypocalcemia

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 279

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 18-5 Explain the role of loop diuretics in the treatment of fluid volume disorders.

Question 9

Type: MCSA

The nurse is preparing to discharge a client who is on multiple medications. The client asks the nurse, “Which medication is a loop diuretic?” What is the best response by the nurse?

1. Spironolactone (Aldactone)
2. Amiloride (Midamor)
3. Chlorthalidone (Hygroton)
4. Furosemide (Lasix)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 279

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 18-5 Explain the role of loop diuretics in the treatment of fluid volume disorders.

Question 10

Type: MCSA

A potassium-sparing diuretic has been prescribed for a client. Based on this prescription, the nurse expects what medication to be ordered?

1. Furosemide (Lasix)
2. Spironolactone (Aldactone)
3. Diltiazem (Cardizem)
4. Hydrochlorothiazide (HCTZ)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 281

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 18-7 Explain the role of potassium-sparing diuretics in the treatment of fluid volume disorders.

Question 11

Type: MCMA

The client has been prescribed a thiazide diuretic. What are the potential adverse effects of thiazide diuretics? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Epistaxis
2. Dizziness
3. Hyperkalemia
4. Hypotension
5. Hypocalcemia

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 280

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 18-6 Explain the role of thiazide diuretics in the treatment of fluid volume disorders.

Question 12

Type: MCSA

A client is receiving a diuretic. The nurse will monitor for which adverse effect?

1. Bradycardia
2. Vomiting
3. Nausea
4. Hypotension

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 279

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 18-4 Identify indications and general uses of diuretics.

Question 13

Type: MCSA

The nurse is caring for a client who has been placed on spironolactone (Aldactone). The nurse assesses this client for hyperkalemia because of which concurrent medication?

1. Prinivil (Zestril)
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Hydrochlorothiazide (HydroDIURIL)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 281

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 18-7 Explain the role of potassium-sparing diuretics in the treatment of fluid volume disorders.

Question 14

Type: MCSA

Which prescribed diuretic can also be used for treatment in certain types of glaucoma?

1. Indapamide (Lozol)
2. Amiloride hydrochloride (Midamor)
3. Mannitol (Osmitrol)
4. Triamterene (Dyrenium)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 282

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 18-8 Explain the role of miscellaneous diuretics in the treatment of fluid volume disorders.

Question 15

Type: MCSA

A client has been diagnosed with hyperkalemia. Which medication would the nurse expect to give?

1. Potassium chloride
2. Furosemide (Lasix)
3. Calcium carbonate (TUMS)
4. Sodium polystyrene sulfate (Kayexalate)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 285

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 18-9 Explain the importance of electrolytes in maintaining homeostasis.

Question 16

Type: MCSA

Why would a client benefit from a thiazide diuretic over a loop diuretic?

1. They can be taken on an as-needed basis.
2. They do not cause electrolyte imbalance.
3. Possible dehydration is not a factor.
4. The frequency of adverse effects is much lower.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 280

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 18-6 Explain the role of thiazide diuretics in the treatment of fluid volume disorders.

Question 17

Type: MCSA

A client is taking spironolactone (Aldactone) but continues to have peripheral edema. Which question by the nurse is the most appropriate?

1. Are you taking potassium supplements?
2. Are you taking corticosteroids?
3. Are you taking digoxin (Lanoxin)?
4. Are you taking aspirin (ASA)?

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 281

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 18-7 Explain the role of potassium-sparing diuretics in the treatment of fluid volume disorders.

Question 18

Type: MCMA

The nurse is providing education to a client who has hypokalemia or low potassium level. Which foods high in potassium should the nurse include in the teaching session? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Dried fruits
2. Broccoli
3. Bananas
4. Peanut butter
5. Coffee

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 285

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 18-9 Explain the importance of electrolytes in maintaining homeostasis.

Question 19

Type: MCSA

The client is prescribed a potassium supplement and spironolactone (Aldactone). Based on this combination, what outcome does the nurse expect?

1. The two medications will be ineffective if taken together.
2. Spironolactone (Aldactone) will lower potassium levels, so a supplement is necessary.
3. These two medications will decrease potassium levels.
4. The client is at risk for hyperkalemia when taking both the supplement and spironolactone (Aldactone).

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 281

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 18-7 Explain the role of potassium-sparing diuretics in the treatment of fluid volume disorders.

Question 20

Type: MCMA

The nurse is presenting education regarding the use of diuretics. What conditions should the nurse include in the educational session regarding the use of diuretics? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Pulmonary edema
2. Heart failure
3. Hypertension
4. Hypotension
5. Seizures

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Numbers: 277–278

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 18-4 Identify indications and general uses for diuretics.

Question 21

Type: MCSA

The client complains of frequent urination at night since starting diuretic therapy. What should the nurse teach this client to alleviate this symptom?

1. Decrease fluid intake.
2. Increase sodium intake.
3. This is an expected effect.
4. Take the medication earlier in the day.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 283

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 18-4 Identify indications and general uses for diuretics.

Question 22

Type: MCSA

A client is admitted to a medical-surgical unit with acidosis. During treatment, the client develops confusion, irritability, slow respiration rate, and vomiting. What does the nurse attribute these symptoms to?

1. Increased blood pressure
2. Overtreatment of acidosis
3. Worsening of acidosis
4. Expected response to treatment

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 286

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 18-10 Identify common causes of acidosis and alkalosis and the drugs to treat these conditions.

Question 23

Type: MCSA

During an admission assessment, the client tells the nurse that they had a nephrectomy three years ago due to a car accident. Which is the nurse’s best understanding of this surgery?

1. The client will have no issues during this hospitalization.

2. The physical therapist should be told this information.

3. The kidney function will impact excretion of medications.

4. The nurse should follow up with the pharmacist regarding the information.

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Page Number: 274

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 18-1 Explain the role of the kidneys in maintaining fluid, electrolyte, and acid–base balance.

Question 24

Type: MCSA

Which diuretics are less commonly prescribed due to their very weak diuresis and higher adverse effects?

1. Loop diuretics

2. Carbonic anhydrase inhibitors

3. Thiazide diuretics

4. Potassium sparing diuretics

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Page Number: 282

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 18-8 Explain the role of miscellaneous diuretics in the treatment of fluid volume disorders.

Question 25

Type: MCSA

Which processes are critical to the pharmacokinetics of many drugs in the kidneys?

1. Reabsorption and secretion

2. Digestion and excretion

3. Diuresis and elimination

4. Ingestion and recirculation

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Page Number: 276

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 18-2 Explain how the processes of reabsorption and secretion can affect the composition of the filtrate.

Question 26

Type: MCMA

Which substances are reabsorbed in the kidney tubules? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Water

2. Hydrogen ions

3. Glucose

4. Sodium

5. Amino acids

Cognitive Level: Remembering

Client Need: Health Promotion and Maintenance

Page Number: 276

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 18-2 Explain how the processes of reabsorption and secretion can affect the composition of the filtrate.